In 2019, Santa Clara County Superintendent Mary Ann Dewan convened district superintendents throughout the county to discuss the concerning rise in students’ mental health diagnoses of depression and anxiety and increasing numbers of death by suicide, as well as increases in substance abuse, self-harm and death by overdose. School leaders agreed they were seeing greater unaddressed mental health needs than ever before and it was significantly impacting student engagement and behavior, especially among middle and high school students. Leaders wanted to take action, but most districts lacked the funding, staff and capacity to take on the issue alone.

The need is not unique to Santa Clara County — between 2007 and 2014, the national suicide rate of children ages 10 to 14 more than doubled, and by 2020 suicide had become the second-leading cause of death among youth, according to the Centers for Disease Control and Prevention.

In response, Santa Clara’s 31 districts agreed to establish a countywide approach, led by Superintendent Dewan and the Santa Clara County Office of Education (SCCOE), to combat the student mental health crisis. SCCOE agreed to build expertise at a countywide level and to seek out grants and partnerships in alliance with school districts. Santa Clara district leaders could not have known it at the time, but their foresight in creating this collaboration would be instrumental in addressing the larger student mental health crisis that would be triggered by the COVID-19 pandemic.

Dewan established the SCCOE Department of Student Health and Wellness and staffed it with mental health and community schools experts who began creating a plan to increase student well-being and engagement. The SCCOE secured grant funding from the Mental Health Student Services Act as well as one of the first California Community Schools Partnership Project grants. Additionally, the COE received statewide technical assistance grants to train school leaders on Medi-Cal billing systems, build partnerships with managed care plans and community-based providers, and develop strategies for building sustainable school-based mental health resources.

In the fall of 2021, SCCOE launched student wellness centers at 12 elementary, middle and high schools. Wellness centers are staffed by a culturally competent liaison who manages the space and interacts daily with students, teachers, parents and school administrators. Each center also employs a licensed or credentialed mental health expert.

To ensure that student wellness centers, staff and activities were aligned with student needs and interests, Dewan established the SCCOE Student Wellness Advisory Group (SWAG) to help guide the work of the new department and inform the countywide implementation of school-based health and wellness services. SWAG members are between the ages of 14 and 25 and are selected to represent the diversity of Santa Clara County’s student body. Since early 2021, students have met monthly to provide guidance to the department, develop messaging on mental health for their peers and advocating for youth wellness initiatives.

Wellness center services vary by campus, but all are designed to be welcoming and calming spaces for students to take a break, practice wellness, engage with curriculum for self-regulation and social-emotional well-being, or seek help from mental health professionals. This approach was informed by SWAG and is modeled on evidence-based practices that seek to reduce mental health stigma and increase student belonging and connectedness to schools, explained Dewan. “Youth highly value the wellness approach and the ability of being able to drop in before, during and after school,” she said. “Sometimes they just need a mindfulness moment or somebody to talk to.”

Within a week of opening their doors, it was clear that the wellness centers were going to be a success. In the first few months, about 7,000 students visited to receive counseling, seek out a calming space, or participate in group-led activities such as art therapy or mindfulness exercises. The centers record 700 student visits per week on average and receive overwhelmingly positive feedback, with nearly 90 percent of students reporting that they left the wellness center feeling better than when they arrived.

Santa Clara County Board of Education President Victoria Chon is a strong proponent of the SCCOE’s student-led approach and highlights the connection between SWAG input and the success of the wellness centers. “Tailoring resources to the needs students have expressed is what shows them the adults care and want to see them succeed in all aspects of their lives,” Chon said.

With student mental health needs continuing to rise as they deal with the long-term impacts of the pandemic and isolation from their peers, Santa Clara has opened an additional seven school-based wellness centers in the 2022–23 school year and provided technical assistance to support many more schools with implementation. Wellness centers address the primary barriers to mental health care for children — transportation, cost, and culturally and age-appropriate services. “Children spend a third of their life at school, so it is no surprise that they are 21 times more likely to receive health and mental health services when those services are provided on a school campus,” Dewan said.

As Santa Clara County leaders continue to push for expansion of school-based mental health services, they are also mindful of the need to build models that are replicable and sustainable. To that end, the SCCOE is working with the county health department, managed care plans, community-based providers and commercial health plans to build partnerships that traverse the often-impenetrable line that exists between the health and education sectors.

“When health systems don’t meet students’ needs, schools feel the impact, and vice versa. Health and education are interdependent,” Dewan said. “When a child is sick or depressed, it impacts attendance, behavior and academic achievement.”